ABSTRACT
Resumo O objetivo deste artigo é analisar a evolução da distribuição de dentistas e cursos de graduação em odontologia no Brasil entre 1960 e 2022, a partir de dados institucionais e de sua correlação com dados econômicos e demográficos. Foram calculadas as proporções entre número de dentistas e população para as unidades federativas em diferentes períodos, e para determinar a concentração de dentistas, da população e dos cursos de graduação em odontologia,foi utilizado o índice Herfindahl-Hirschman (HHI). Para testar a correlação entre variáveis foi empregado o teste de Pearson, com um nível de significância de 95%. Entre 1960 e 2022, a proporção de dentistas por 10 mil habitantes aumentou de 3,3 para 16,9. Ainda em 2022, as unidades federativas com maior renda média domiciliar per capita estavam fortemente correlacionadas à maior concentração de dentistas (R2 = 0,90; p < 0,00). Entretanto, de 1975 a 2022, a concentração de dentistas medida pelo HHI caiu de 45,1 para 33,4. A diminuição da concentração geográfica dos cursos de odontologia foi ainda mais pronunciada, tendo o HHI passado de 39,3 em 1991 para 25,6 em 2022.
Abstract The scope of this article is to analyze the evolution of the distribution of dentists and undergraduate courses in Dentistry in Brazil between 1960 and 2022, based on institutional data and its correlation with economic and demographic data. The proportions between number of dentists and population were calculated for the federative units in different periods, and the Herfindahl-Hirschman Index (HHI) was used. to determine the concentration of dentists, population and undergraduate courses in Dentistry. The Pearson test was used, with a significance level of 95%, to test the correlation between variables. In the period from 1960 to 2022, the ratio of dentists per 10,000 inhabitants increased from 3.3 to 16.9. Moreover in 2022, the federative units with the highest average household income per capita were closely correlated with the highest concentration of dentists (R2= 0.90; p < 0.00). However, from 1975 to 2022, the concentration of dentists measured by the HHI dropped from 45.1 to 33.4. The decrease in the geographic concentration of Dentistry courses was even more pronounced, with the HHI rising from 39.3 in 1991, to 25.6 in 2022.
ABSTRACT
Introducción: Cuba comenzó de manera temprana sus preparativos ante la emergencia por COVID-19 y ha desplegado muchas capacidades científico-técnicas para su enfrentamiento, entre ellas la gestión de sistemas de información geográfica, a cargo de la empresa GEOCUBA. Objetivo: Identificar posibles sitios de riesgo geoespacial relacionados con la transmisión de COVID-19 en Santiago de Cuba. Métodos: Se desarrolló un estudio ecológico. Se identificaron grupos de transmisión de COVID-19 y riesgos epidemiológicos. Se resumieron variables epidemiológicas, sociales y espaciales. Se realizaron análisis espaciales y sobrevuelos de dron como técnicas de telepidemiología. Resultados: Se identificaron cinco grupos espaciales de transmisión, uno en el municipio Palma Soriano, uno en Contramaestre y tres en Santiago de Cuba. Las distancias espaciales entre casos y confirmados se relacionaron con la forma de transmisión de la COVID-19. Se identificaron bajas tasas de incidencia. Se apreció baja movilidad, cumplimiento de medidas de distanciamiento y protección social. Conclusiones: La creación de un grupo multidisciplinario en Santiago de Cuba, a propuesta de las máximas estructuras del partido y el gobierno, garantizó el despliegue de recursos tecnológicos para el uso de la telepidemiología, lo que permitió la identificación espacial y posterior gestión integral de riesgos ecoepidemiológicos relacionados con la transmisión de COVID-19 en Santiago de Cuba. Las acciones gubernamentales diferenciadas, la percepción de riesgo de la población y la respuesta comunitaria influyeron en las bajas tasas de transmisión y dispersión espacial de la enfermedad, lo que muestra la importancia de la concepción de la salud como producto social(AU)
Introduction: Cuba early started its preparations to face the emergency due to COVID-19 and it has made a deployment of several scientific-technical capacities for it, among them the management of geographical information's systems by GEOCUBA company. Objective: Identify posible sites of geospatial risk related with the transmission of COVID-19 in Santiago de Cuba province. Methods: It was developed an ecologic study. There were identified groups of COVID-19 transmission and epidemiological risks. Epidemiological, social and spatial variables were resumed. Also there were made spatial analyses and overflights of drones as teleepidemiology techniques. Results: There were identified five spatial groups of transmission: one in Palma Soriano municipality, one in Contramaestre municipality and three in Santiago de Cuba municipality. The spatial distances among the cases and confirmed cases were related with the form of transmission of COVID-19. There were identified low incidence rates. It was noticed low mobility, accomplishment of the social distancing rules and social protection. Conclusions: The creation of a multidisciplinary group in Santiago de Cuba province, as a proposal of the highest level of the Communist Party and the Government, secured the deployment of technologic resources for the use of telepidemiology, and this allowed the spatial identification and further comprehensive management of ecoepidemiologic risks related with the transmission of COVID-19 in Santiago de Cuba. The different governmental actions, the perception of risk of the population, and the community response impacted in the low rates of transmission and spatial spreading of the disease, which shows the importance of worthing health as a social productAU)